Abstract
OBJECTIVE: To analyze the effect of sperm DNA fragmentation index (DFI) on the outcomes of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). METHODS: Literature search was conducted on English databases PubMed, Cochrane, and Embase to obtain eligible studies. RESULTS: A total of 11 cohort studies were included and analyzed using the random effects model. The results illustrated that the IVF fertilization rate (RR = 0.94, 95% CI: 0.77-1.14, P = 0.61), pregnancy rate (RR = 0.83, 95% CI: 0.57-1.21, P = 0.32), and live birth rate (RR = 0.53, 95% CI: 0.16-1.80, P = 0.31) in the high DFI group were statistically insignificant with those in the low FI group. The correlations between DFI and ICSI fertilization rate (RR = 0.79, 95% CI: 0.52-1.18, P = 0.25), pregnancy rate (RR = 0.89, 95% CI: 0.74-1.06, P = 0.18), and live birth rate (RR = 0.89, 95% CI: 0.70-1.14, P = 0.36) were also not statistically significant. CONCLUSION: This study has observed no significant correlation between sperm DFI and assisted reproductive outcomes. Multicenter large-sample clinical trials are required to conclusively determine the impact of DNA damage on the clinical outcomes of assisted reproduction.